JOB EVALUATION WORKING PARTY (JEWP II) - FACTOR DEFINITIONS AND FACTOR LEVELS (14/2/02)

1.	COMMUNICATION & RELATIONSHIP SKILLS

This factor measures the skills required to communicate, establish and maintain relationships and gain the co-operation of others. It takes account of the skills required to motivate, negotiate, persuade, make presentations, train others, empathise, communicate unpleasant news sensitively and provide counselling and re-assurance. It also takes account of difficulties involved in exercising these skills.

Skills required for:

Level 1:	Providing and receiving routine information orally to assist in undertaking own job. Communication is mainly with work colleagues.
Level 2:	Providing and receiving routine information orally, in writing or electronically to inform work colleagues, patients, clients, carers, the public or other external contacts.
Level 3:	(a) Providing and receiving routine information which requires tact or persuasive skills or where there are barriers to understanding. or (b) Providing and receiving complex or sensitive information. or (c) Providing advice, instruction or training to groups, where the subject matter is straightforward.
Level 4:	Providing and receiving complex, sensitive or contentious information, where persuasive, motivational, negotiating, training, empathic or re-assurance skills are required. This may be because agreement or co-operation is required or because there are barriers to understanding.
Level 5:	(a) Providing and receiving highly complex, sensitive or contentious information, where developed persuasive, motivational, negotiating, training, empathic or re-assurance skills are required. This may be because agreement or co-operation is required or because there are barriers to understanding. or (b) Presenting complex, sensitive or contentious information to a large group of staff or members of the public. or (c) Providing and receiving complex, sensitive or contentious information, where there are significant barriers to acceptance which need to be overcome using developed interpersonal and communication skills such as would be required when communicating in a hostile, antagonistic or highly emotive atmosphere.
Level 6:	Providing and receiving highly complex, sensitive or contentious information where there are significant barriers to acceptance which need to be overcome using the highest level of interpersonal and communication skills, such as would be required when communicating in a hostile, antagonistic or highly emotive atmosphere.

DEFINITIONS AND NOTES:

From Level 2 upwards communication may be to work colleagues, staff, patients, clients, carers, public or other external contacts.

Barriers to understanding (Levels 3 to 5) refers to situations where the audience may not easily understand because of cultural or language differences, or physical or mental special needs.

From Level 3 upwards information may be transmitted, or interpersonal skills exercised, orally, in writing, electronically, or using sign language, or other verbal or non-verbal forms of communication, including empathy. A requirement to communicate in a language other than English is also included.

Complex (Levels 3 to 6) means complicated and made up of several components. Most clinical jobs would normally be providing or receiving complex information.

Training…..where the subject matter is straightforward (Level 3c) refers to training topics such as manual handling; new equipment familiarisation; hygiene health and safety.

Highly complex, sensitive or contentious (Levels 5 and 6) refers to situations where the jobholder has extremely complicated strands of communication which may be conflicting or where the communication topic is extremely delicate or likely to cause offence. It also covers situations where highly complex ideas or concepts need to be conveyed in easily understood language.

2.	KNOWLEDGE, TRAINING & EXPERIENCE

This factor measures all the forms of knowledge required to fulfil the job responsibilities satisfactorily. This includes theoretical and practical knowledge; professional, specialist or technical knowledge; and knowledge of the policies, practices and procedures associated with the job. It takes account of the educational level normally expected as well as the equivalent level of knowledge gained without undertaking a formal course of study; and the practical experience required to fulfil the job responsibilities satisfactorily.

The job requires:

Level 1:	Understanding of a limited number of routine work procedures which could be gained through a short induction period or on the job training.
Level 2:	Understanding of a range of routine work procedures possibly outside immediate work area, which would require job training and a period of induction.
Level 3:	Understanding of a range of work procedures and practices, some of which are non-routine, which require a base level of theoretical knowledge. This is normally acquired through formal training or equivalent experience.
Level 4:	Understanding of a range of work procedures and practices, the majority of which are non-routine, which require intermediate level theoretical knowledge. This knowledge is normally acquired through formal training or equivalent experience.
Level 5:	Understanding of a range of work procedures and practices, which requires expertise within a specialism or discipline, underpinned by theoretical knowledge or relevant practical experience.
Level 6:	Specialist knowledge across the range of work procedures and practices underpinned by theoretical knowledge or relevant practical experience
Level 7:	Highly developed specialist knowledge across the range of work procedures and practices underpinned by theoretical knowledge and relevant practical experience
Level 8:	(a) Advanced theoretical and practical knowledge of a range of work procedures and practices, or (b) Specialist knowledge over more than one discipline/function acquired over a significant period.

DEFINITIONS AND NOTES:

Short induction period (Level 1) is generally for days not weeks

Job Training (Level 2) would include training for HGV and PSV licences.

Base level of theoretical knowledge (Level 3) would equate to NVQ level 3, RSA 3, City & Guilds certification or equivalent level of knowledge.

Equivalent experience (Levels 3 and 4) refers to experience which would enable the job holder to gain an equivalent level of knowledge.

Intermediate level of theoretical knowledge (Level 4) would equate to a BTEC or other diploma or equivalent level of knowledge.

Expertise within a specialism (Level 5) would normally require degree level or equivalent level of knowledge. Jobs requiring knowledge normally acquired through training for RGN should be scored at this level.

Specialist knowledge (Level 6) refers to a level of knowledge and expertise which can be acquired through either in-depth experience or theoretical study to post-registration/graduate diploma level or equivalent in a specific field, for example the qualifications required for district nursing, social work or physiotherapy.

Highly developed specialist knowledge (Level 7) refers to knowledge and expertise which can only be acquired through a combination of in depth experience and post graduate or post registration study, such as would be obtained through a Master’s degree or doctorate in a relevant field. Jobs requiring knowledge normally acquired through training for medical qualifications should be scored at this level.

Advanced theoretical and practical knowledge (Level 8) refers to the highest level of specialist knowledge within the relevant specialist field. It is appropriate for posts requiring significant expertise and experience and where the minimum level of qualification is a doctorate or equivalent.

Specialist knowledge over more than one discipline/function (level 8) refers to extensive knowledge and expertise across a number of subject areas, for example, a combination of areas such as clinical, research and development, personnel and finance.

Notes:

1) The minimum qualification and/or experience requirements should be taken to be those necessary to enable a replacement to carry out the same duties as the current jobholder.

2) In the event that the minimum qualification and /or experience requirements for a job have changed, the current requirements should be taken as the necessary standard to be achieved.

3.	ANALYTICAL AND JUDGEMENTAL SKILLS

This factor measures the analytical and judgemental skills required to fulfil the job responsibilities satisfactorily. It takes account of requirements for analytical skills to diagnose a problem or illness and understand complex situations or information; and judgemental skills to formulate solutions and recommend/decide on the best course of action/treatment.

Skills required for:

Level 1:	Judgements involving straightforward job-related facts or situations.
Level 2:	Judgements involving facts or situations, some of which require analysis.
Level 3:	Judgements involving a range of facts or situations, which require analysis or comparison of a range of options.
Level 4:	Judgements involving complex facts or situations, which require the analysis, interpretation and comparison of a range of options.
Level 5:	Judgements involving highly complex facts or situations, which require the analysis, interpretation and comparison of a range of options.

DEFINITIONS AND NOTES:

Range of facts or situations which require analysis, interpretation and comparison… (Level 3) includes both clinical and non clinical facts/situations. This type of analysis and judgement would typically be carried out by qualified professionals.

Complex (Level 4) means complicated and made up of several components, which may be conflicting.

Highly complex (Level 5) means complicated and made up of several components, which may be conflicting and where expert opinion differs or some information is unavailable.

4.	PLANNING AND ORGANISATIONAL SKILLS

This factor measures the planning and organisational skills required to fulfil the job responsibilities satisfactorily. It takes account of the skills required for activities such as planning or organising clinical or non-clinical services, departments, rotas, meetings, conferences and for strategic planning. It also takes account of the complexity and degree of uncertainty involved in these activities.

Skills required for:

Level 1:	Little or no planning activity.
Level 2:	Planning and organisation of straightforward tasks, activities or programmes, some of which may be ongoing.
Level 3:	Planning and organisation of a number of complex activities or programmes, which require the formulation and adjustment of plans.
Level 4:	Planning and organisation of a broad range of complex activities or programmes, some of which are ongoing, which require the formulation and adjustment of plans or strategies.
Level 5:	Formulating long-term, strategic plans, which involve uncertainty and which may impact across the whole organisation.

DEFINITIONS AND NOTES:

Planning and organisation of straightforward tasks… (Level 2) includes planning and organising of own time or that of others e.g. planning non-complex staff rotas, clinics or parent-craft classes or where there is a need to make short term adjustments to plans. This type of planning would typically be carried out by qualified professionals.

Straightforward tasks, activities or programmes (Level 2) means several tasks, activities or programmes, which are individually uncomplicated such as arranging meetings.

Planning and organisation of a number of complex activities (Level 3) includes co-ordinating activities and arranging multi-disciplinary activities with other professionals and agencies, for example, case conferences, discharge planning.

Complex (Levels 3 and 4) means complicated and made up of several components, which may be conflicting.

5.	PHYSICAL SKILLS

This factor measures the physical skills required to fulfil the job duties. It takes into account hand-eye co-ordination, sensory skills (sight, hearing, touch, taste, smell), dexterity, manipulation, requirements for speed and accuracy, keyboard and driving skills.

Level 1:	The post has minimal demand for work related physical skills.
Level 2:	The post requires physical skills which are normally obtained through practice over a period of time or during practical training, for example, standard driving or keyboard skills; use of some tools and types of equipment.
Level 3:	(a) The post requires physical skills to fulfil duties where there is a specific requirement for speed or accuracy. This level of skill may be required for advanced or high speed driving; advanced keyboard use; or manipulation of objects or people with narrow margins for error. or (b) The post requires highly developed physical skills, where accuracy is important, but there is no specific requirement for speed. This level of skill may be required for manipulation of fine tools or materials.
Level 4:	The post requires highly developed physical skills where a high degree of precision or speed and high levels of hand, eye and sensory co-ordination are essential.
Level 5:	The post requires the highest level of physical skills where a high degree of precision or speed and the highest levels of hand, eye and sensory co-ordination are essential.

DEFINITIONS AND NOTES:

Standard keyboard skills (Level 2): includes the skills exercised by those who have learned over time and those who have been trained to RSA1 or equivalent.

Specific requirement (Level 3a) means that the job demands are above average.

Advanced or high speed driving (Level 3a) includes driving a heavy goods vehicle, ambulance, minibus or articulated lorry where an HGV, PSV, PCV, or Ambulance Driving Test or equivalent is required..

Advanced keyboard use (Level 3a) includes the skills exercised by qualified typists (RSA 2/3 or equivalent).

Restraint of patients/clients (Level 3a) indicates a skill level that requires a formal course of training and regular updating.

Manipulation of fine tools or materials (Level 3b) includes, for example, manipulation of materials on a slide or under a microscope, assembly of surgical equipment, intravenous injections.

Highly developed physical skills (Level 4) could include, for example, the skills required for surgical intervention, intubation, tracheotomies, suturing or manual physiotherapy treatment.

Highest level of physical skill (Level 5) includes, for example, keyhole or laser surgery or IVF procedures.

6.	RESPONSIBILITIES FOR PATIENT/ CLIENT CARE

This factor measures responsibilities for patient/client care, treatment and therapy. It takes account of the nature of the responsibility and the level of the jobholder's involvement in the provision of care or treatment to patients/clients, including the degree to which the responsibility is shared with others.

Level 1:	Little or no responsibility for patient/client care.
Level 2:	Provides general non-clinical advice, information, guidance or ancillary services directly to patients, clients, relatives or carers.
Level 3:	(a) Provides personal care to patients/clients. or (b) Provides basic clinical technical services for patients/clients. or (c) Provides basic clinical advice
Level 4:	(a) Implements clinical care / care packages. or (b) Provides clinical technical services to patients/clients. or (c)Provides advice in relation to the care of individual, or groups of patients/clients.
Level 5:	(a) Develops programmes of care/care packages. or (b) Provides specialist clinical technical services. or (c) Provides specialised advice in relation to the care of patients/clients.
Level 6:	(a) Develops specialised programmes of care/ care packages. or (b) Provides highly specialist clinical technical services. or (c) Provides highly specialised advice concerning the care or treatment of identified groups or categories of patients/clients. or (d) Accountable for the direct delivery of a service within a sub-division of a clinical, clinical technical or social care service.
Level 7:	Accountable for the direct delivery of a clinical, clinical technical, or social care service(s).
Level 8:	Corporate responsibility for the provision of a clinical, clinical technical or social care service(s).

DEFINITIONS AND NOTES:

At Level 2 or above, the activities should be a significant or major aspect of normal duties.

Directly to patients/clients (Level 2): on a one to one, individual basis, usually face to face or over the telephone, for example, reception or switchboard services, food delivery service, ward or theatre cleaning.

Personal care (Level 3a): includes assisting with feeding, bathing, appearance, portering supplied directly to patients/clients.

Basic clinical technical services (Level 3b): includes cleaning, sterilising or packing specialist equipment or facilities used in the provision of clinical services, for example, sterile supplies, theatres, laboratories; the routine obtaining or processing of diagnostic test samples.

Basic clinical advice (Level 3c): includes the provision of straightforward clinical advice to patients/clients by people who are not clinical specialists, for example an ambulance switchboard operator.

Implementing care (Level 4a): carrying out programmes of care, therapy or treatment determined by others, for example, supervising individual or group therapy sessions to meet with overall requirements: this may include making minor modifications within prescribed parameters, reporting back on progress.

Provides clinical technical services (Level 4b): for example, initial screening of diagnostic test samples, dispensing of medicines.

Provides advice (Level 4c): provides advice which contributes to the care, well being or education of patients/clients, including health promotion.

Develops programmes of care/care packages (Level 5a): involves assessment of care needs and development of suitable care programmes/packages, to be implemented by the postholder or by others.

Provides specialist clinical technical services (Level 5b): e.g. interprets diagnostic test results, carries out complex diagnostic procedures.

Provides specialised advice (Level 5c): provides specialised advice, which contributes to the diagnosis, care or education of patients/clients.

Provides highly specialised advice, (Level 6c): provides highly specialised advice, which contributes to the diagnosis, care or education of patients/clients in an expert area of practice.

Within a sub division of (Level 6d): refers to either a geographical or functional sub division.

Accountable for direct delivery (Level 7) refers to the accountability vested in jobholders who directly manage the providers of direct patient/client care but may not provide direct care themselves, for example, Head of Midwifery.

Corporate responsibility (Level 8) refers to the accountability for clinical governance across the organisation, for example, Director of Nursing and Midwifery Services.

Clinical service refers to services such as oncology and paediatrics.

Clinical technical service refers to services such as medical physics, audiology and laboratory haematology.

Social care service refers to services such as child protection and learning disabilities.

7.	RESPONSIBILITIES FOR POLICY AND SERVICE DEVELOPMENT IMPLEMENTATION

This factor measures the responsibilities of the job for development and implementation of policy and/or services. It takes account of the nature of the responsibility and the extent and level of the jobholder’s contribution to the relevant decision making process, for instance, making recommendations to decision makers. It also takes account of whether the relevant policies or services relate to a function, department, division, directorate, the whole trust or employing organisation, or wider than this; and the degree to which the responsibility is shared with others.

Level 1:	Follows policies in own role which are determined by others, no responsibility for service development, but may be required to comment on policies, procedures or possible developments.
Level 2:	Implements policies within determined parameters and proposes changes to working practices or procedures for own work area.
Level 3:	Implements policies for own area and/or proposes policy or service changes which impact beyond own area of activity.
Level 4:	Responsible for policy implementation and for discrete policy or service development for a service or more than one area of activity.
Level 5:	Responsible for a range of policy implementation and policy or service development for a directorate or equivalent.
Level 6:	Corporate responsibility for major policy implementation and policy or service development, which impacts across or beyond the organisation.

DEFINITIONS AND NOTES:

Implements policies (Level 2 and above) refers to the introduction of new or revised policies where the job holder is active in either making it happen, or ensuring that others make it happen.

Impact beyond own area of activity (level 3) includes participation on working parties proposing policy changes.

Beyond area of activity refers to a function/ service /discipline and not a geographic area. It does not refer, for example, to the same function/ service /discipline in other parts of the Trust / organisation.

Service refers to services such as oncology, haematology, child protection, catering and accounts.

Corporate responsibility refers to responsibility for policy or service development across the whole organisation.

8.	RESPONSIBILITIES FOR FINANCIAL AND PHYSICAL RESOURCES

This factor measures the responsibilities of the job for financial resources (including cash, vouchers, cheques, debits and credits, invoices, budgets, revenues, income generation); and physical assets (including clinical, office and other equipment; tools and instruments; vehicles, plant and machinery; premises, fittings and fixtures; personal possessions of patients/clients or others; goods, produce, stocks and supplies).

It takes account of the nature of the responsibility (for example, careful use, security, maintenance, budgetary and ordering responsibilities); the frequency with which it is exercised; the value of the resources; and the degree to which the responsibility is shared with others.

Level 1:	Little or no direct responsibility for financial and/or physical assets; little or no impact on budgetary costs, other than a need to observe a personal duty of care.
Level 2:	(a) Regularly handles or processes cash, cheques, patients’ valuables. or (b) Responsible for the safe use of equipment other than equipment which they personally use. or (c) Responsible for maintaining stock control and/or security of stock. or (d) Authorised signatory for small cash/financial payments. or (e) Responsible for the safe use of expensive or highly complex equipment
Level 3:	(a) Authorised signatory for cash/financial payments. or (b) Responsible for the purchase of some physical assets or supplies. or (c) Monitors or contributes to the formulation of department/service budgets or financial initiatives, or (d) Holds a delegated budget from a budget for a department/service. or (e) Responsible for repair and maintenance of physical assets.
Level 4:	(a) Budget holder for a department/service. or (b) Responsible for budget setting for a department/service. or (c) Responsible for the procurement or maintenance of all physical assets or supplies for a department/service.
Level 5:	(a) Responsible for the budget for several services. or (b) Responsible for budget setting for several services. or (c) Responsible for physical assets for several services.
Level 6:	Corporate responsibility for the financial resources and physical assets of an organisation.

DEFINITIONS AND NOTES:

Regularly (Level 2a): at least once a week on average

Safe use of equipment (Level 2b): includes dismantling ands assembling equipment for use by others. [Note: Use of communal equipment would score at level 1]. It also includes overall responsibility for office machinery or cleaning equipment .

Security of stock (Level 2c): is appropriate for jobs where the responsibility is a significant feature of the job, for example, responsible for the security of a large amount /volume of drugs /materials.

Authorised signatory for small cash/financial payments (level 2d): includes for example, "signing off" travel expenses or overtime payments totalling less than £1,000 per month.

Expensive (Level 2e): means equals £30,000.

Authorised signatory (Level 3a): includes for example, "signing off" travel expenses or overtime payments totalling £1,000 or more per month.

Responsible for the purchase of some physical assets (Level 3b): the value of the assets must be circa £5,000 or greater.

Financial initiatives (Level 3c) includes income generation and cost improvement programmes.

Budget holder (Level 4): responsible for authorising expenditure and accountable for expenditure within an allocated budget.

Budget setting (Levels 4b and 5b): an accounting activity, responsible for overseeing the financial position.

Corporate responsibility (level 6) refers to responsibility for financial governance across the whole organisation.

9.	RESPONSIBILITIES FOR HUMAN RESOURCES

This factor measures the responsibilities of the job for management, supervision, co-ordination, teaching, training and development of employees, students/ trainees and others in an equivalent position.

It includes work planning and allocation; checking and evaluating work; undertaking clinical supervision; identifying training needs; developing and/or implementing training programmes; teaching staff, students or trainees; and continuing professional development (CPD). It also includes responsibility for such personnel functions as recruitment, discipline, appraisal and career development; and the long term development of human resources.

The emphasis is on the nature of the responsibility, rather than the precise numbers of those supervised, co-ordinated, trained or developed.

Level 1:	Little or no responsibility for staff or human resources, but may include some induction of new employees and the demonstration of activities or workplace routines.
Level 2:	(a) Responsible for day to day supervision or co-ordination of staff within a section/function of a department/service. or (b) Regularly responsible for professional /clinical supervision of a small number of qualified staff or students or (c) Regularly responsible for providing practical training or undertaking basic workplace assessments. or (d) Regularly responsible for the provision of basic HR advice.
Level 3:	(a) Responsible for day to day management of a group of staff. or (b) Responsible for the allocation or placement and subsequent supervision of qualified staff or students or (c) Responsible for the teaching/delivery of core training o a range of subjects. or (d) Responsible for the delivery of core HR advice on a range of subjects.
Level 4:	(a) Responsible as line manager for a single function or department. or (b) Responsible for the teaching or devising of training and development programmes as a major job responsibility. or (c) Responsible for the delivery of a comprehensive range of HR services.
Level 5:	(a) Responsible as line manager for several/multiple departments. or (b) Responsible for the management of a teaching/training function across the organisation. or (c) Responsible for the management of a significant part of the HR function across the organisation.
Level 6:	Corporate responsibility for the human resources or HR function.

DEFINITIONS AND NOTES:

Day to day supervision or co-ordination (Level 2a): includes work allocation and checking

Professional and clinical supervision (Level 2b): is the process by which professional and clinical practitioners are able to reflect on their professional practice in order to improve, identify training needs and develop. It can be conducted by a peer or superior. It is not for the purpose of appraisal or assessment and only for the purpose of improving practice in context of clinical governance etc.

Regularly (Level 2b,c,d): at least once a week on average but could be in more concentrated blocks e.g. 6 weeks every year. Above level 2 the responsibility must be ongoing.

Practical training (Level 2c): for example, training in lifting and handling, COSSH regulations.

Day to day management (Level 3a): includes responsibility for informal grievance and discipline; acting as an appointment panel member; work allocation and checking

Responsibility for allocation or placement and subsequent supervision (level 3b): includes liaison with training providers, allocation of students/ trainees to staff for training purposes, ensuring that student/trainee records or assessments are completed.

Single function (Level 4a): any unit of equivalent scope to a department there is a significant management responsibility; the diversity and scope of the workforce supervised should also be taken into consideration.

Line manager (Level 4a): includes responsibility for chairing appointment panels; appraisals; sickness absence; disciplinary matters; career development.

Corporate responsibility (Level 6) refers to responsibility for human resources across the whole organisation.

10.

RESPONSIBILITIES FOR INFORMATION RESOURCES

This factor measures the responsibilities of the job for all forms of information resources (for example, computerised; paper based; microfiche, images, X rays, ultrasound scans) and information systems (both hardware and software, for example, medical records, payroll and personnel systems).

It takes account of the nature of the responsibility (security; processing and generating information; creation, updating and maintenance of information databases or systems); and the degree to which it is shared with others. It assumes that all information encountered in the NHS is confidential.

Level 1:	Little or no responsibility for data entry, text processing or storage of information resources.
Level 2:	Responsible for data entry, text processing or storage of data, utilising paper or computer based data entry systems.
Level 3:	Responsible for generating information: (a) manually, for example, taking and transcribing formal minutes or (b) using of a computerised system and familiarity with one or more software packages.
Level 4:	Responsible for adapting information systems to meet the specifications of others.
Level 5:	Responsible for the design and development of significant in formation systems to meet the specifications of others.
Level 6:	Responsible for the management of information and systems and the development of systems at department/service level, including information services e.g. news, public relations, health promotion, medical records.
Level 7:	Corporate responsibility for the provision of information systems/services for the organisation.

DEFINITIONS AND NOTES:

Data entry, text processing or storage of data (level 2): includes word processing or typing documents or notes compiled by others (for example, test results, correspondence, medical or personnel records); collating or compiling statistics from existing records; ‘pulling’ and/or filing of medical, personnel or similar records. It does not include recording clinical observations or test results, which are taken into account under the Responsibility for Patient/Client Care factor.

Generating information manually (level 3a) includes taking and transcribing formal minutes, for instance, of board meetings or case conferences, where this is a significant job responsibility. It does not include taking notes at meetings, or processing notes taken by others.

Familiarity with software packages (level 3b) must include responsibility for the creation of formats, databases and spreadsheets.

Corporate responsibility (level 6) refers to responsibility for information resources across the whole organisation

11.

RESPONSIBILITIES FOR RESEARCH AND DEVELOPMENT

This factor measures the responsibilities of the job for informal and formal clinical or non-clinical research and development activities underpinned by appropriate methodology and documentation, including formal testing or evaluation of drugs, or clinical or non-clinical equipment.

It takes into account the nature of the responsibility (initiation, implementation, oversight of research and development activities), whether it is an integral part of the work or research for personal development purposes; and the degree to which it is shared with others.

Level 1:	Little or no responsibility for research and development.
Level 2:	(a) Occasionally undertakes R & D activity as a requirement of the job or (b) Occasionally participates in clinical trials or equipment testing. or (c) Regularly undertakes surveys or audits
Level 3:	(a) Regularly participates in R & D activity as a requirement of the job or (b) Regularly participates in clinical trials or (c)Regularly participates in equipment testing or adaptation.
Level 4:	Carries out research or development work as part of one or more formal research programmes or activities as a major job requirement.
Level 5:	Responsible for co-ordinating and implementing R & D programmes or activity as a requirement of the job.
Level 6:	Responsible, as an integral part of the job, for initiating (which may involve securing funding) and developing R & D programmes or activities, which support the objectives of the broader organisation.
Level 7:	Responsible, as an integral part of the job, for initiating and developing R & D programmes, which have an impact outside the organisation, e.g. NHS wide or outside the Health Service.

DEFINITIONS AND NOTES:

Research and development (All levels): this includes testing of, for example drugs and equipment and other forms of formal non-clinical research (e.g. human resources, communications, health education) as well as formal clinical research. This factor measures the requirement for active direct participation in trials and does not include indirect involvement as a result of a patient being involved in the research.

Participates in clinical trials or equipment testing (Level 2b): is when active participation is required

Occasionally (Levels 2a & 2b): would indicate one or two such projects or activities per year.

Regularly (Levels 3a, 3b & 3c): would be appropriate where it is a regular feature of the work, normally identified in a job description, with relevant activity at least once a month on average and usually more frequently.

Major job requirement (Level 4): would indicate involvement for at least some part of every working week.

Level 6: would be appropriate where the jobholder is required to specify and develop R&D programmes and get these off the ground.

12.

FREEDOM TO ACT

This factor measures the extent to which the jobholder is required to be accountable for own actions and those of others, to use own initiative and act independently; and the discretion allowed to the jobholder to take action.

It takes account of any restrictions on the jobholder’s freedom to act imposed by, for example, supervisory control; instructions, procedures, practices and policies; professional, technical or occupational codes of practice or other ethical guidelines; the nature or system in which the job operates; the position of the job within the organisation; and the existence of any statutory responsibility for service provision.

Level 1:	Generally works with supervision close by and within well-established procedures and/or practices and has standards and results to be achieved.
Level 2:	Is guided by standard operating procedures, good practice, established precedents and understands what results or standards are to be achieved. Someone is generally available for reference and work may be checked on a sample/random basis.
Level 3:	Is guided by precedent and clearly defined occupational policies, protocol/procedures or codes of conduct. Work is managed, rather than supervised, and results/outcomes are assessed at agreed intervals.
Level 4:	Expected results are defined but the post holder decides how they are best achieved. Is guided by principles and broad occupational policies or regulations. Guidance may be provided by peers or external reference points.
Level 5:	Is guided by general health, organisational or broad occupational policies, but in most situations the post holder will need to establish the way in which these should be interpreted.
Level 6:	Is required to interpret overall health service policy and strategy, in order to establish goals and standards.

DEFINITIONS AND NOTES:

Work is managed, rather than supervised, (Level 3): would be appropriate for clinical /professional jobs where post holders are required to act independently within appropriate clinical/professional guidelines and refer to their manager when necessary.

Is guided by principles and broad occupational policies (Level 4): would apply to those who are the only specialist in a particular field for example, a physiotherapist specialising in chest treatments. It would also apply to clinical /professional managers who have the freedom to initiate action within broad clinical / professional policies, seeking guidance from others as necessary.

Establish the way in which these should be interpreted (Level 5): indicates freedom to take action based on own interpretation of broad clinical / professional policies, where necessary .

Is required to interpret overall health service policy and strategy (Level 6): would be appropriate for jobs with an ongoing requirement to act with minimal guidelines and set goals and standards for others.

13.

PHYSICAL EFFORT

This factor measures the nature, level, frequency and duration of the physical effort (sustained effort at a similar level or sudden explosive effort) required for the job. It takes account of any circumstances that may affect the degree of effort required, such as working in an awkward position or confined space.

The job requires:

Level 1:	A combination of sitting, standing and walking with little requirement for physical effort. There may be a requirement to exert light physical effort for short periods.
Level 2:	(a) There is a frequent requirement for sitting or standing in a restricted position for a substantial proportion of the working time. or (b) There is a frequent requirement for light physical effort for several short periods during a shift. or (c) There is an occasional requirement to exert light physical effort for several long periods during a shift. or (d) There is an occasional requirement to exert moderate physical effort for several short periods during a shift.
Level 3:	(a) There is a frequent requirement to exert light physical effort for several long periods during a shift. or (b) There is an occasional requirement to exert moderate physical effort for several long periods during a shift. or (c) There is a frequent requirement to exert moderate physical effort for several short periods during a shift.
Level 4:	(a) There is an ongoing requirement to exert light physical effort. or (b) There is a frequent requirement to exert moderate physical effort for several long periods during a shift. or (c) There is an occasional requirement to exert intense physical effort for several short periods during a shift.
Level 5:	(a) There is an ongoing requirement to exert moderate physical effort. or (b) There is a frequent requirement to exert intense physical effort for several short periods during a shift. or (c) There is an occasional requirement to exert intense physical effort for several long periods during a shift.

DEFINITIONS AND NOTES:

Light physical effort (Levels 2 – 4) means lifting, pushing, pulling objects weighing from 2-5 kilos; bending / kneeling / crawling; working in cramped conditions; working at heights; walking more than a kilometre at any one time.

Sitting or standing in a restricted position (level 2a): restricted by the nature of the work in a position which cannot easily be changed, for example, inputting at a keyboard, wearing a telephone headset, in a driving position, sitting at a microscope examining slides; standing at a machine in a restricted area; standing while serving or making sandwiches.

Moderate physical effort (Levels 2-5) means lifting, pushing, pulling objects weighing from 6 -15 kilos; controlled restraint of patients; sudden explosive effort such as running from a standing start; moving patients/heavy weights (over 15 kilos) with mechanical aids including hoists and trolleys or clearing tables.

Intense physical effort (Levels 4-5) means lifting, pushing, pulling objects weighing over 15 kilos with no mechanical aids; sudden explosive effort such as running from a standing start pushing a trolley; heavy manual digging, lifting a Bain Marie, pot washing.

Occasional: on fewer than half the shifts worked, a shift being a period of work.

Frequent: occurs on half the shifts or more, a shift being a period of work.

Several periods: this applies to jobs where there are repeated recurrences of physical effort and would not normally be used for jobs where the effort in question occurs only once per shift. For example, level 3(c) applies to jobs involving the repeated moving or manoeuvring of patients, with mechanical or human assistance, into positions in which care or treatment can be carried out.

Ongoing: continuously or almost continuously.

Weights quoted are illustrative only. Evaluators should take into account the difficulty of the lifting.

Short periods are up to and including 20 minutes.

Long periods over 20 minutes.

Walking or driving to work is not included.

14.

MENTAL EFFORT

This factor measures the nature, level, frequency and duration of the mental effort required for the job (for example concentration; responding to unpredictable work patterns, interruptions and the need to meet deadlines).

Level 1:	General awareness and sensory attention; normal care and attention; an occasional requirement for concentration where the work pattern is predictable with few competing demands for attention.
Level 2:	(a) There is a frequent requirement for concentration where the work pattern is predictable with few competing demands for attention. or (b) There is an occasional requirement for concentration where the work pattern is unpredictable.
Level 3:	(a) There is a frequent requirement for concentration where the work pattern is unpredictable. or (b) There is an occasional requirement for prolonged concentration.
Level 4:	(a) There is a frequent requirement for prolonged concentration. or (b) There is an occasional requirement for intense concentration.
Level 5:	There is a frequent requirement for intense concentration.

DEFINITIONS AND NOTES:

General awareness and sensory attention (Level 1) is the level required for carrying out day-to-day activities.

Concentration (Levels 1 to 4) is where the jobholder needs to be particularly alert for periods of one to two hours at a time, for example when checking documents; carrying out calculations or analysing statistics; operating machinery; driving a vehicle; taking detailed minutes of meetings; carrying out screening tests /microscope work;

Unpredictable (Levels 2 & 3): where the job holder is required to change from one activity to another at third party request. Dealing with frequent interruptions (as in telephone or reception work) is not unpredictable unless they frequently cause the post holder to change from what they are doing to another activity (e.g. responding to emergency bleep, or changing from one accounting task to another in response to requests for specific information).

Intense concentration(Levels 4b & 5): in-depth mental attention, for example carrying out intricate clinical interventions; undergoing cross examination in court.

Occasional: fewer than half the shifts worked. A shift being a period of work.

Frequent: occurs on half the shifts worked or more. A shift being a period of work.

Prolonged: refers to a requirement to concentrate for more than half a shift on average.

15.

EMOTIONAL EFFORT

This factor measures the nature, level, frequency and duration demands of the emotional effort required to undertake clinical or non-clinical duties that are generally considered to be distressing and/or emotionally demanding.

Level 1:	Little or no exposure to distressing or emotional circumstances.
Level 2:	Occasional exposure to distressing or emotional circumstances.
Level 3:	(a) Frequent exposure to distressing or emotional circumstances. or (b) Occasional exposure to highly distressing or highly emotional circumstances. .
Level 4:	(a) Occasional exposure to traumatic circumstances. or (b) Frequent exposure to highly distressing or highly emotional circumstances.

DEFINITIONS AND NOTES:

Exposure: relates to actual incidents but can be either direct or indirect, for example, a non-clinical job in a clinical area could involve indirect exposure to distressing or emotional circumstances. Indirect exposure will generally reduce the level of intensity, so, for example, indirect exposure to highly distressing circumstances (e.g. word processing reports of child abuse) should be treated as equivalent to direct exposure to distressing circumstances.

Distressing or emotional circumstances (Levels 1 to 3) for example

Imparting unwelcome news to staff, patients/clients or relatives. This could include disciplinary or grievance matters, planned re-organisations

Care of the terminally ill.

Dealing with difficult family situations or circumstances

Highly distressing or emotional circumstances (Levels 3 and 4)

This could include imparting news of terminal illness or neonatal death to patients and relatives, child abuse, family breakdown.

Traumatic incidents (Level 4) for example arriving at scene of, or dealing with patients/relatives as a result of, a serious incident.

Occasional: at least once a month on average.

Frequent: means at least once a week on average.

Fear of violence is measured under Working Conditions.

16.

WORKING CONDITIONS

This factor measures the nature, level, frequency and duration of demands arising from inevitably adverse environmental conditions (such as extreme heat/cold, smells, noise, and fumes) and hazards, which are unavoidable (even with the strictest health and safety controls), such as road traffic accidents, spills of harmful chemicals, aggressive behaviour of patients, clients, relatives, carers.

Level 1:	Little or no exposure to unpleasant working conditions or hazards.
Level 2:	(a) Occasional exposure to unpleasant working conditions. or (b) Occasional requirement to drive / be driven in emergency situations or (c) Frequent requirement to drive / be driven. or (d) Frequent requirement to work out doors. or (e) Requirement to use VDU equipment more or less continuously on most days.
Level 3:	(a) Frequent exposure to unpleasant working conditions. or (b) Occasional exposure to highly unpleasant working conditions.
Level 4:	(a) Some exposure to hazards. or (b)Frequent exposure to highly unpleasant working conditions.
Level 5:	Considerable exposure to hazards.

DEFINITIONS AND NOTES:

Exposure to (Level 1 upwards) means direct exposure and does not include being in the vicinity of the unpleasant /highly unpleasant working condition.

Unpleasant working conditions (Levels 1 to 3): include dirt, dust, smell, noise, extreme heat and cold.

Highly unpleasant working conditions (Levels 3 to 4): direct contact with fleas, lice, body fluids, foul linen, noxious fumes.

Hazards (Levels 4 to 5): unavoidable exposure to, for example, face to face physical aggression, spills of harmful chemicals, road traffic accidents.

Little: 1 or 2 times a month.

Occasional: at least 3 times a month

Frequent: several times a week with several occurrences on each relevant shift.

Driving to and from work is NOT included.